Health Economics Unit, Centre for Health Policy, School of Population and Global Health, The University of Melbourne, Level 4, 207 Bouverie St, Parkville, VIC, 3010, Australia.
Music Therapy, Faculty of Fine Arts and Music, The University of Melbourne, Melbourne, Australia.
Popul Health Metr. 2022 Jul 27;20(1):17. doi: 10.1186/s12963-022-00294-3.
This study compares the health gains, costs, and cost-effectiveness of hundreds of Australian and New Zealand (NZ) health interventions conducted with comparable methods in an online interactive league table designed to inform policy.
A literature review was conducted to identify peer-reviewed evaluations (2010 to 2018) arising from the Australia Cost-Effectiveness research and NZ Burden of Disease Epidemiology, Equity and Cost-Effectiveness Programmes, or using similar methodology, with: health gains quantified as health-adjusted life years (HALYs); net health system costs and/or incremental cost-effectiveness ratio; time horizon of at least 10 years; and 3% to 5% discount rates.
We identified 384 evaluations that met the inclusion criteria, covering 14 intervention domains: alcohol; cancer; cannabis; communicable disease; cardiovascular disease; diabetes; diet; injury; mental illness; other non-communicable diseases; overweight and obesity; physical inactivity; salt; and tobacco. There were large variations in health gain across evaluations: 33.9% gained less than 0.1 HALYs per 1000 people in the total population over the remainder of their lifespan, through to 13.0% gaining > 10 HALYs per 1000 people. Over a third (38.8%) of evaluations were cost-saving.
League tables of comparably conducted evaluations illustrate the large health gain (and cost) variations per capita between interventions, in addition to cost-effectiveness. Further work can test the utility of this league table with policy-makers and researchers.
本研究通过在线互动排行榜，对澳大利亚和新西兰（NZ）数百项采用可比方法进行的健康干预措施的健康收益、成本和成本效益进行了比较，旨在为政策提供信息。
我们进行了文献回顾，以确定在澳大利亚成本效益研究和 NZ 疾病负担的流行病学、公平性和成本效益计划中产生的同行评议评估（2010 年至 2018 年），或使用类似的方法，具有以下特点：健康收益量化为健康调整生命年（HALYs）；净卫生系统成本和/或增量成本效益比；至少 10 年的时间范围；以及 3%至 5%的贴现率。
我们确定了 384 项符合纳入标准的评估，涵盖了 14 个干预领域：酒精；癌症；大麻；传染病；心血管疾病；糖尿病；饮食；伤害；精神疾病；其他非传染性疾病；超重和肥胖；身体活动不足；盐；和烟草。在整个剩余寿命中，每 1000 人中健康收益的变化幅度很大：33.9%的人获得的健康调整生命年少于 0.1 个，而 13.0%的人获得的健康调整生命年超过 10 个。超过三分之一（38.8%）的评估具有成本效益。
可比评估的排行榜除了成本效益外，还说明了干预措施之间人均健康收益（和成本）的巨大差异。进一步的工作可以用政策制定者和研究人员来测试这个排行榜的实用性。
